Oedema- Symptoms & Causes ( Exclusive Post 2021)

Oedema
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Oedema

 Abnormal and excessive accumulations of fluid within the interstitial spaces or cavities.

 

Types

I. Depending on extents

 

1. Localized edema

– Localised to an organ or limb. For e.g

– Inflammatory

– Lymphatic

– Toxic

 

2. Generalized edema

– It is a systemic in distribution ( anasarca or dropsy)

– For e.g

– Cardiac

– Renal

– Nutritional

 

II. Depending on nature of fluid

– Exudative

– Transudative

 

III. Depending in depth of fluid displacement

 

1. Pitting edema

Pressure by finger produces a depression

For e.g edema in subcutaneous

 

2. Non pitting edema

There is no depression on pressure ( soild edema)

For e.g  Myxoedema, elephantias etc

 

IV. Others

Pulmonary edema

Cerebral edema

 

Signs and symptoms

Swelling

Warmth

Redness

Pain and tenderness

Pitting or non- pitting edema

Loss of skin crease or texture

Rashes, itching

 

Assessment and physiotherapy management

A. Data Base

  • Name
  • Age
  • Sex
  • Occupation

 

B. Subjective assessment

  • Chief complaints
  • History
  • Onset
  • Duration
  • Intensity
  • Cause
  • Any surgical / medical history
  • Family history

 

C. Objective assessment

 

i. On Observation

– Built of patient

– Attitude of limbs

– Swelling

– Any surgical notes

– Side, site of edema

– Trophic changes

– Peripheral pulsations

– Temperature

 

ii. On examination

– Edema

– Pitting/ non-pitting

– Brawny edema

– Wheeping

– MMT of muscles

– ROM of joints active and passive

– Limb and muscle girth measurement

– Volumetric measurement

 

Levels of limbs measurements

 

A. For upper limb

Axilla

8cm proximal to olecranon process

11cm distal to olecranon

Wrist level of thumb

 

B. For lower limb

Groin

15 cm above patella

15 cm below patella

Ankle (malleoli)

Middle of metatarsals

 

Both affected and unaffected limbs must be measured

 

Physiotherapy management

1. Elevation of the affected limb

2. Application if anti-embolic stocking and pressure bandage, lymphedema sleeves

3. Faradism under pressure if the joints are unable to move due to severe accumulation of fluid and pain.

4. Pneumatic compression machine

– Intermittent mode

– Squential mode

– It helps to give compression to the limb from distal to proximal

 

5. Soft tissue manipulation

– Massage

– Kneading, stroking, efflurage

– Ultrasound

– Pulsed electromagnetic energy

 

6. Exercise

– Distal joint mobilization

– Active movement pf involved joint in elevated position.

– It helps in mobilization of fluid from the subcutaneous tissue.

– It can be done 4-5 time/day

– Ankle/toe movement, wrist finger flexion, extension

 

7. Advise to the patient

– Prevent prolonged standing or walking or in dependent position.

– Keep the affected limb in elevated position.

– Prevent any injury over the affected limb due to high chances of infection.

– Do not take hot baths

– Do not wear tight bands, ankle, rings or jewelry on the swollen limb.

– Wear appropriate foot wear elastic stockings.

 

 


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